Does the use of low frequency ultrasonic debridement pose an infection control risk for clinicians, patients and the clinic environment?

Ms Lucia Michailidis1,2, Dr Despina Kotsanas2, Ms Elizabeth Orr2, Ms Georgia Coombes1, Dr Shan Bergin2, Professor Terry Haines3, Dr Cylie Williams1,3

1Peninsula Health, Frankston, Australia, 2Monash Health, Clayton South, Australia, 3Monash University, Frankston, Australia


Low Frequency Ultrasonic Debridement (LFUD) is a technology using sound waves conducted through saline to debride wounds.  Whilst this treatment reduces wound healing times, the airborne mist generated is potentially problematic.  This research aims to establish the degree and extent to which there is microbial spread during and following the use of LFUD with and without the suction attachment.

Testing was performed on ward and in the outpatient setting.  Data was collected before, during and after twenty-four treatments with twelve treatments on ward and twelve treatments in the outpatient setting.  Six of the ‘on ward’ treatments and six of the ‘outpatient room’ treatments were performed without the suction attachment and six with suction.

There was a higher microbial count during treatment (p<0.001). A higher microbial count was associated with lower amplitude (p=0.028), lower flow (p=0.010), no suction (p>0.001) and larger wounds, (p=0.002).  There was no correlation between handpiece type, wound infection and treatment time or treatment environment.  Even with suction, there was heavy growth noted following some treatments of from microbes such as Staphylococcus aureus, Streptococcus agalactiae and Corynebacterium resistens.

The results should not dissuade clinicians from using LFUD but it is vital that treatment be performed under the correct conditions to mitigate microorganism aerosolisation.  This research has assisted in developing guidelines for the use.


Lucia completed a Bachelor of Podiatry at La Trobe University in 2008.  On completion of the degree she was the recipient of an Award for Excellence in clinical practice by the Australian Podiatry Association (Vic) and attained inclusion on the La Trobe University Dean’s Honours List.

She has worked at three of Victoria’s largest health networks over the past eight years and is well experienced in managing the high-risk foot population in the Melbourne Metropolitan area.

Lucia is currently undertaking her PhD investigating the use of low frequency ultrasonic debridement compared with non-surgical sharps debridement in the management of diabetes-related foot ulcers.